Clinical Financial Case Manager - RN

A company is looking for a Clinical Financial Case Management - RN. Key Responsibilities Implement and support clinical pre-certifications, case reviews, and denial management Utilize clinical knowledge to interpret medical necessity guidelines and determine appropriate levels of care Serve as a Subject Matter Expert for assigned payers and maintain awareness of healthcare trends and guidelines Required Qualifications Bachelor's degree in nursing with a current license Minimum of 3 years of clinical care experience Experience collaborating with physicians and understanding care plans Strong analytical skills and ability to make informed decisions Proficiency in Microsoft Office and various technology applications

Mar 7, 2025 - 17:55

A company is looking for a Clinical Financial Case Management - RN. Key Responsibilities Implement and support clinical pre-certifications, case reviews, and denial management Utilize clinical knowledge to interpret medical necessity guidelines and determine appropriate levels of care Serve as a Subject Matter Expert for assigned payers and maintain awareness of healthcare trends and guidelines Required Qualifications Bachelor's degree in nursing with a current license Minimum of 3 years of clinical care experience Experience collaborating with physicians and understanding care plans Strong analytical skills and ability to make informed decisions Proficiency in Microsoft Office and various technology applications